| NPI | 1083892020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G63783) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: CA G63783) |
| 207Q00000X Family Medicine (Licence: OR MD16862) | |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2020-03-04 |